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  <meta name="title" content="FirstClass Account Request" />
  <meta name="author" content="Sothea Nim" />
  <meta name="description" content="FirstClass Account Request" />
  <meta name="developer" content="Sothea Nim, snimwork@gmail.com" />
  <title>Lab Account Request</title>
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<div id="bodyContainer">

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<h1>Lab Account Request</h1>
<br />
<form method="post" action="index.html" name="fcAccountRequest" onsubmit="return validateForm(this);">

<table cellpadding="0" cellspacing="0" id="content">

<tr valign="top">
	<td>First Name: </td>
	<td><input type="text" name="fname" /></td>
</tr>
<tr valign="top">
	<td>Last Name: </td>
	<td><input type="text" name="lname" id="lname" onKeyup="clearField('netname');"/></td>
</tr>
<tr valign="top">
	<td>Student ID: </td>
	<td><input type="text" name="studentid" maxlength=7 onKeyup="if(this.value.length == 7){ getNetname(this.value, document.getElementById('lname').value, 'http://doe.concordia.ca/techprojects/lab-account-request/libraries/', 'getNetname', 'netname'); } else { clearField('netname'); }" /></td>
</tr>
<tr valign="top">
	<td>Netname: </td>
	<td><span id="netname"><input type="text" name="netname" id="netname" /></span></td>
</tr>
<!---
<tr valign="top">
	<td>Email: </td>
	<td><span id="email"><input type="text" name="email" id="email" /></span>
	@education.concordia.ca</td>
</tr>
--->
<tr valign="top">
	<td>Program of Study: </td>
	<!--<td><input type="text" name="program" /></td>-->
    <td><select name="program">
    		<option value="default">Select One</option>
    		<option value="PhD Education">Ph.D. Education</option>
            <option value="Applied Linguistics">Applied Linguistics</option>
            <option value="Child Study">Child Study</option>
            <option value="Educational Studies">Educational Studies</option>
            <option value="Educational Technology">Educational Technology</option>
            <option value="Adult Education">Adult Education</option>
            <option value="Instructional Technology">Instructional Technology</option>
            <option value="Faculty and Staff">Faculty and Staff</option>
        </select>
    </td>
</tr>

</table>
<br />

<input type="submit" name="fcAccountRequest" value="Request">
<input type="reset" name="fcAccountRequest" value="Reset" onclick="javascript:location.reload(true)">
</form>

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